Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103K00000X | Behavior Analyst | ||
Y | 103TS0200X | School Psychologist | 153968 | CO |
N | 103TS0200X | School Psychologist | 735811 | NJ |
NPI | 1033418132 |
---|---|
Provider Name | Georginia Bucca Weygand |
First Address | Centennial, CO 80112-6820 |
Second Address | Centennial, CO 80112-6820 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/03/2011 |
Last Update Date | 22/12/2021 |